Two-item PROMIS® global physical and mental health scales

Ron D Hays, Benjamin D Schalet, Karen L Spritzer, David Cella, Ron D Hays, Benjamin D Schalet, Karen L Spritzer, David Cella

Abstract

Background: Self-reports of health provide useful information about function and well-being that can improve communication between patients and clinicians. Global health items provide summary information that are predictive of health care utilization and mortality. There is a need for parsimonious global health scales for use in large sample surveys. This study evaluates the reliability and validity of brief measures of global physical health and mental health in the Patient Reported Outcomes Measurement and Information System (PROMIS®) project.

Methods: A total of 21,133 persons included in the PROMIS development sample: 52% female; 82% White, 9% Black, 9% Hispanic; median age of 50 years. We identified two global physical health items (GPH-2) and two global mental health items (GMH-2) with highest discrimination parameters and compared their reliabilities and construct validity to that of the original 4-item scales (GPH-4 and GMH-4) and a single global health item (Global01).

Results: Internal consistency reliability was 0.73 for the GPH-2 (versus 0.81 for the GPH-4) and 0.81 for the GMH-2 (versus 0.86 for the GMH-4). Marginal reliabilities were 0.55 for Global01, 0.70 for GPH-2, 0.79 for GPH-4, 0.80 for GMH-2, and 0.86 for GMH-4. The product-moment correlation between the GPH-2 and GPH-4 was 0.94 and between GMH-2 and GMH-4 was 0.97. The 2-item and 4-item versions of the scales had similar correlations with PROMIS domain scores, the EQ-5D-3L and comorbidities, but the 4-item scales were more strongly correlated with these measures.

Conclusions: Adding a single item to a large cross-sectional population survey can cost as much as $100,000. The 2-item variants of the PROMIS global health scales reduce the cost of use on national surveys by 50%, a substantial cost savings. These briefer scales are also more practical for use in clinical practice. The 2-item versions of the PROMIS global health scales display adequate reliability for group comparisons and their associations with other indicators of health are similar to that of the original 4-item scales. The briefer scales are psychometrically sound and reduce burden of survey administration.

Keywords: Global health; PROMIS®; Patient-reported outcomes.

Conflict of interest statement

The study was conducted in accordance with the Declaration of Helsinki and patients provided informed consent to participate.The authors have no conflicts of interests associated with this manuscript.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Cella D, Riley W, Stone A, et al. Initial item banks and first wave testing of the patient-reported outcomes measurement information system (PROMIS) network: 2005-2008. J Clin Epidemiol. 2010;63:1179–1194. doi: 10.1016/j.jclinepi.2010.04.011.
    1. Snyder CF, Aaronson NK, Choucair AK, Elliott TE, Greenhalgh J, Halyard MY, Hess R, Miller DM, Reeve BB, Santana M. Implementing patient-reported outcomes assessment in clinical practice: A review of the options and considerations. Qual Life Res. 2012;21(8):1305–1314. doi: 10.1007/s11136-011-0054-x.
    1. DeSalvo KB, Bloser N, Reynolds K, et al. Mortality prediction with a single general self-rated health question; a meta-analysis. J Gen Intern Med. 2006;21:267–275. doi: 10.1111/j.1525-1497.2005.00291.x.
    1. Riley WT, Rothrock N, Bruce B, Christodolou C, Cook K, Hahn EA, Cella D. Patient-reported outcomes measurement information system (PROMIS) domain names and definitions revisions: Further evaluation of content validity in IRT-derived item banks. Qual Life Res. 2010;19(9):1311–1321. doi: 10.1007/s11136-010-9694-5.
    1. Stewart AL, Hays RD, Ware JE. Health perceptions, energy/fatigue, and health distress measures. In: Stewart AL, Ware JE, editors. Measuring functioning and well-being: The medical outcomes study approach. Durham, NC: Duke University Press; 1992.
    1. Hays RD, Spritzer KL, Thompson WW, et al. U.S. general population estimate for “excellent” to “poor” self-rated health item. J Gen Intern Med. 2015;30:1511–1516. doi: 10.1007/s11606-015-3290-x.
    1. Hays RD, Reise S, Calderón JL. How much is lost in using single items? J Gen Intern Med. 2013;27:1402–1403. doi: 10.1007/s11606-012-2182-6.
    1. Hays RD, Liu H, Kapteyn A. Use of internet panels to conduct surveys. Behav Res Methods. 2015;47(3):685–690. doi: 10.3758/s13428-015-0617-9.
    1. Liu HH, Cella D, Gershon R, Shen J, Morales LS, Riley W, Hays RD. Representativeness of the PROMIS internet panel. J Clin Epidemiol. 2010;63(11):1169–1178. doi: 10.1016/j.jclinepi.2009.11.021.
    1. Revicki DA, Kawata AK, Harnam N, Chen W-H, Hays RD, Cella D. Predicting EuroQol (EQ-5D) scores from the patient-reported outcomes measurement information system (PROMIS) global items and domain item banks in a United States sample. Qual Life Res. 2009;18:783–791. doi: 10.1007/s11136-009-9489-8.
    1. Hays RD, Bjorner J, Revicki DA, et al. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009;18:873–880. doi: 10.1007/s11136-009-9496-9.
    1. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334. doi: 10.1007/BF02310555.
    1. Nunnally JC. Assessment of reliability. In: Psychometric theory (2nd ed.) New York: McGraw-Hill; 1978.
    1. Nelson, E. C., Wasson, J. H., Johnson, D. J., & Hays, R. D. (1996). Dartmouth COOP functional health measurement charts: Brief measures for clinical practice. In B. Spilker (Ed.), Quality of life and Pharmacoeconomics in clinical trials (2nd ed., pp. 161–168). New York: Lippincott-Raven Publishers.
    1. Wasson, J., Keller, A., Rubenstein, L., Hays, R. D., Nelson E., Johnson, D. & Dartmouth primary care COOP staff. (1992). Benefits and obstacles of health status assessment in ambulatory settings: The clinician’s point of view. Med Care, 30, 42–49s.

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